Utility of 3-dimensional ultrasound imaging to evaluate carotid artery stenosis: comparison with magnetic resonance angiography

J Stroke Cerebrovasc Dis. 2015 Jan;24(1):148-53. doi: 10.1016/j.jstrokecerebrovasdis.2014.08.007. Epub 2014 Oct 16.

Abstract

Background: We evaluated the utility of 3-dimensional (3-D) ultrasound imaging for assessment of carotid artery stenosis, as compared with similar assessment via magnetic resonance angiography (MRA).

Methods: Subjects comprised 58 patients with carotid stenosis who underwent both 3-D ultrasound imaging and MRA. We studied whether abnormal findings detected by ultrasound imaging could be diagnosed using MRA. Ultrasound images were generated using Voluson 730 Expert and Voluson E8.

Results: The degree of stenosis was mild in 17, moderate in 16, and severe in 25 patients, according to ultrasound imaging. Stenosis could not be recognized using MRA in 4 of 17 patients diagnosed with mild stenosis using ultrasound imaging. Ultrasound imaging showed ulceration in 13 patients and mobile plaque in 6 patients. When assessing these patients, MRA showed ulceration in only 2 of 13 patients and did not detect mobile plaque in any of these 6 patients. Static 3-D B mode images demonstrated distributions of plaque, ulceration, and mobile plaque, and static 3-D flow images showed flow configuration as a total structure. Real-time 3-D B mode images demonstrated plaque and vessel movement. Carotid artery stenting was not selected for patients diagnosed with ulceration or mobile plaque.

Conclusions: Ultrasound imaging was necessary to detect mild stenosis, ulcerated plaque, or mobile plaque in comparison with MRA, and 3-D ultrasound imaging was useful to recognize carotid stenosis and flow pattern as a total structure by static and real-time 3-D demonstration. This information may contribute to surgical planning.

Keywords: 3-dimensional ultrasonography; Carotid artery stenosis; magnetic resonance angiography; mobile plaque; ulceration.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology
  • Carotid Stenosis / diagnosis*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / pathology
  • Female
  • Headache / etiology
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional / methods*
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Paresis / etiology
  • Ulcer / pathology
  • Ultrasonography / methods*